Individual provider Active NPI

Kristin Elizabeth Gay, NCLEC,ABO

  • Optician
  • Sumter, SC
National Provider Identifier
1932672490
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
1210 Issued in SC
Practice address
365 W Wesmark Blvd
Sumter, SC 29150-1987
Phone
(803) 905-8047
Fax
(803) 905-8090
NPI assigned
Jan 8, 2019
Last updated
Jan 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 1210 SC Primary

Addresses

Primary practice location

365 W Wesmark Blvd
Sumter, SC 29150-1987

Mailing address

365 W Wesmark Blvd
Sumter, SC 29150-1987
Phone (803) 905-8047

Other identifiers 1

IdentifierTypeStateIssuer
1801945019MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1932672490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501987",
            "telephone_number": "803-905-8047",
            "fax_number": "803-905-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501987",
            "telephone_number": "803-905-8047",
            "fax_number": "803-905-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAY",
        "first_name": "KRISTIN",
        "middle_name": "ELIZABETH",
        "credential": "NCLEC,ABO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "SC",
            "license": "1210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801945019",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.